Riding a emotional roller coaster with PCOS

Mental health issues affect individuals of all genders and should not be overlooked or left untreated. Especially in this patriarchal society, certain needs of women are overlooked very often. Only when the condition is life-threatening / life-altering attention is spared.

Posted on March 9, 2023

Reviewed by

Dr Ankita S


How often do we give importance to our mental and emotional health?

Mental health issues affect individuals of all genders and should not be overlooked or left untreated. Especially in this patriarchal society, certain needs of women are overlooked very often. Only when the condition is life-threatening / life-altering attention is spared.

It is important to be mindful of the unique needs and experiences of women, and to provide support and resources to address mental health concerns.

Women with polycystic ovary syndrome (PCOS) are more susceptible to experience depression and anxiety, which can have a significant impact on their emotional well-being. Oftentimes, mental health issues associated with PCOS are neglected and left untreated due to a lack of awareness.

Emotional well-being and PCOS:

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women that commonly in their reproductive years. Women with PCOS experience complaints like depression, anxiety, negative body image, and low self-esteem. In particular, depression is significantly higher and seems to be consistently elevated with their lifespan.

Let’s talk about the emotional struggles we go through day in and day out because of PCOS:

“Mood swings” is a common term we hear on daily basis. So, what are mood swings? Mood swings are one moment you are laughing with your friends and the next moment you are tearing up for no obvious reason,sudden shifts in your mood can make you feel overwhelmed, tired, or out of control. If this is recurring and consistent we might need professional intervention as it can disrupt the quality of life.

Let’s understand what causes mood swings from the biopsychological perspective. There are several hormones in women which is responsible for menstruation such as FSH, estrogen, progesterone, etc.
When there is an imbalance in levels of estrogen and progesterone there can be a shift in the mood of the person. Serotonin is a neurotransmitter that is responsible for the regulation of mood.

Low levels of serotonin may lead to disturbances in sleep, overthinking, increase in anxiety levels along with mood swings which naturally cause irritability and other affective disorders.

Over the years several studies have shown empirical evidence that women with PCOS have a high correlation in getting depression and anxiety. Therefore, let’s understand what depression and anxiety are.


Simply put, depression is when a person experiences constant mental fatigue and low mood due to a lack of mental energy. The lack of mental energy naturally leads to a lack of interest in things we once enjoyed, changes in appetite, changes in the sleep cycle, changes in body weight, and little to no interest in socialising. There is also an increase in cognitive distortions which are errors in our thinking pattern that could lead to problems in interpersonal communication.


When the person has no control over their thoughts, it leads to constant worrying and nervousness; we constantly think about all the possible worst-case scenarios which increases stress levels. Anxiety can be manifested physically in the form of headaches, dizziness, lightheadedness, nausea, and gut problems like irritable bowel syndrome (IBS) or constipation.

The effects of depression and anxiety:

How depression and anxiety affect our quality of life (QOL) are:
Physically-low levels of serotonin can affect the appetite, it can either be an increase or decrease in food intake, oversleeping or deprivation of sleep, weight loss, or weight gain that can consecutively disrupt our physical health as well.

  • Psychologically- When there is a lack of mood regulation and there is a consistent drop in our mood that can lead to a lack of motivation. It could affect our sense of accomplishment which gives us the momentum to stay motivated. A low sense of accomplishment leads to low self-esteem and self-worth.
  • Socially- Low levels of mental energy lead to a lack of interest in socialising which leads to the ending of several relationships. Due to a lack of motivation and irritability, there can be conflicts in the work environment.

Mental well-being and PCOS:

Research shows that experiencing the symptoms of PCOS, including excess hair growth, hair loss, acne, weight changes, and fertility problems, can negatively affect mood, self-confidence, and body image. It has also been shown that the longer it takes for a woman to receive a diagnosis of PCOS, the more likely she is to be depressed or anxious. It can be difficult to cope with the symptoms of PCOS especially if you don’t know the cause.

Reactions to the diagnosis:

Being diagnosed with a chronic disease such as PCOS can generate a range of feelings and emotions. Often, these are similar to a grief reaction. Not everyone will experience these feelings. In no particular order, the reactions can be:


Having a diagnosis and living with a condition such as PCOS can cause stress.
Stress occurs when you feel threatened or feel you cannot cope with a situation. A little stress can motivate you to act, but too much stress, particularly over a long period, can take its toll on your health and sense of well-being.
It’s helpful to take time to work out what can cause you stress.
Physiologically stress increases the levels of a hormone called cortisol.
High levels of cortisol can cause fatigue, weight gain, breakouts and skin changes, inflammation, and sexual dysfunction. Increased cortisol level contributes to insulin resistance in women with PCOS which makes the process of weight loss even harder.

Body image and PCOS:

Body image is the way a person thinks or feels about their body. It can be influenced by many factors, including a person’s understanding of their health, their attitudes towards physical appearance, their physical fitness, body size, and their personal or cultural values.

The physical changes of PCOS can affect our body image. Many of the symptoms of PCOS challenge our ideas about femininity and how women are ‘supposed’ to look. Many women with PCOS feel less physically attractive, physically fit, and healthy. This can be very difficult to cope with emotionally.

PCOS can make some women feel self-conscious and affect their behaviour. At different times of your life, different symptoms of PCOS can concern you more. If symptoms such as acne and excess hair growth are of concern to you and affect how you think about your body, it is important to seek treatment for these symptoms.

If PCOS is affecting the way you feel about your body, or your behaviour, talk to a health professional and/or a person you trust.

Ways to self-regulate emotions:


Mental health and physical health cannot be separated. They are colossally integrated. It is advisable to seek professional help when you are suffering emotionally, especially with PCOS. An increase in depression and anxiety levels can lead to suicidal tendencies. Experiencing suicidal thoughts does not make you a weak person, it is just an indication that you are suffering. As the saying goes, “if you know how to suffer you suffer less”. It is time we put an end to our misery.

Frequently Asked Questions

PCOS can lead to emotional struggles such as depression, anxiety, mood swings, and low self-esteem due to hormonal imbalances and other factors.

Yes, mood swings can be a common symptom of PCOS due to hormonal fluctuations, particularly changes in estrogen and progesterone levels.

Depression and anxiety can affect physical health, emotional well-being, motivation, self-esteem, relationships, and social interactions, leading to a reduced quality of life.

Yes, stress can exacerbate PCOS symptoms by increasing cortisol levels and contributing to insulin resistance, weight gain, and other issues.

Practicing mindfulness, following a routine, engaging in physical activities, spending time in nature, and expressing emotions through creative outlets can help in self-regulating emotions and managing emotional well-being.

Reviewed by

Dr Ankita S


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